With the explosion of biomedical publishing in the latter half of the 20th century, keeping up with primary research has become an impossible feat for policy makers and practitioners. There has been a proliferation of systematic reviews as one of the key tools for evidence-based health care. This presents both opportunities and risks. The opportunities are to base decisions on accurate, succinct, credible comprehensive and comprehensible summaries of the best available evidence on a topic.

The goal was to create a valid reliable and useable instrument that will help users differentiate between systematic reviews, based on their quality, and to facilitate the development of high-quality reviews. This exercise led to AMSTAR and was reported in a series of papers. Candidate domain items were identified through a review of the evidence and existing tools. Nominal group consensus methods were used to identify best items and to gauge face validity. A comparison among the draft instrument and competing instruments was undertaken to establish its measurement properties. AMSTAR, the resulting instrument has good inter-rater agreement, test-retest reliability, face and construct validity, and is easy to use.

We believe that AMSTAR has significantly advanced the practice of assessing the methodological quality of systematic reviews. It has received endorsements from the Canadian Agency for Drugs and Technologies in Health CADTH and several authors and had been cited nearly 400 times as of early 2013. It has been translated into Japanese, French and Spanish. It is used to evaluate reviews, as a guide to conduct of reviews and as an aid to teaching about systematic reviews.